Provider Demographics
NPI:1831686229
Name:SUPERIOR MEDICAL GROUP LLC
Entity type:Organization
Organization Name:SUPERIOR MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JANG
Authorized Official - Middle Name:SUK
Authorized Official - Last Name:MUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-643-0740
Mailing Address - Street 1:6850 N DURANGO DR STE 211
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-4597
Mailing Address - Country:US
Mailing Address - Phone:702-643-0740
Mailing Address - Fax:888-291-5713
Practice Address - Street 1:6850 N DURANGO DR STE 211
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4597
Practice Address - Country:US
Practice Address - Phone:702-643-0740
Practice Address - Fax:888-291-5713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11549207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty